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Course information.

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Course*
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8-week MSC Dates*

Please select the dates required

8-Week MSC Term 2 - Cumberland Park*

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8-Week MSC Term 4 - Cumberland Park*

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5-day MSC dates*

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MSC 5-Day Intensive, 16th - 19th March, 2018*

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Wise Compassion Workshop dates*

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Wise Compassion Workshop 5th August 2017*

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Retreat Day dates*

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Retreat Day Saturday 3rd February 2018*

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Retreat Day Saturday 7th April 2018*

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Retreat Day Saturday 2nd June 2018*

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Retreat Day Saturday 4th August 2018*

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Retreat Day Saturday 6th October 2018*

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Retreat Day Saturday 1st December 2018*

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Registration Data

First Name*
Please let us know your first name.

Last Name*
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Age (Optional)

Contact Number*
Please let us know your Contact Number.

Preferred contact time
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Your Email*
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Postcode

Do you have any special conditions to be catered for (e.g. dietary, accessibility, etc.)?

Further Information only for MSC Programs

What interests you about the program and what are you hoping to gain?

Can you make the commitment to attend all sessions?
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Can you make the commitment to practice the mindfulness and compassion skills in between each session?
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Please share details of any previous meditation experience

Please note any current mental health problems or significant life issues you are experiencing

If so, are you under the care of a mental health practitioner?
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Compassionate Choices

I have printed and completed this form, as a reminder for myself that I understand the importance of being responsible for my own wellbeing throughout the MSC course
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Note: The Compassionate Choices form can be downloaded here.
You do not need to return this form.

Payment Details

Fee type*
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Fee type*
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Preferred payment option *
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If you are applying for a concession rate, please share a little about your current circumstances

Additional Information

Are you happy to subscribe to our quarterly newsletter?
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How did you hear about Adelaide Mindfulness?

Please include any comments or questions you may have

Privacy Policy & Terms and Conditions

We value our community and ensure the data we collect is handled sensitively, securely, and with due regard for personal privacy. We will not release your email address or personal information to any other party.

Submission of this registration form is not confirmation of your position in the program/ workshop. We will be in touch with you shortly to confirm your place and discuss payment details.

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